Dobutamine-CMR with myocardial tagging detected significantly more new wall motion abnormalities compared to dobutamine-CMR without tagging (35.1% vs 29.9%; P=0.002).
Observational (n=211)
Does high-dose dobutamine cardiovascular magnetic resonance with myocardial tagging improve the detection of new wall motion abnormalities compared to without tagging in patients with chest pain?
Dobutamine-CMR with myocardial tagging significantly improves the detection of ischemic wall motion abnormalities compared to standard dobutamine-CMR and identifies patients at low risk for future cardiovascular events.
Absolute Event Rate: 35.1% vs 29.9%
p-value: p=0.002
BACKGROUND: The purpose of this study was to assess the value of high-dose dobutamine cardiovascular magnetic resonance (CMR) with myocardial tagging for the detection of wall motion abnormalities as a measure of myocardial ischemia in patients with known or suspected coronary artery disease. METHODS AND RESULTS: Two hundred eleven consecutive patients with chest pain underwent dobutamine-CMR 4 days after antianginal medication was stopped. Dobutamine-CMR was performed at rest and during increasing doses of dobutamine. Cine-images were acquired during breath-hold with and without myocardial tagging at 3 short-axis levels. Regional wall motion was assessed in a 16-segment short-axis model. Patients with new wall motion abnormalities (NWMA) were examined by coronary angiography. Dobutamine-CMR was successfully performed in 194 patients. Dobutamine-CMR without tagging detected NWMA in 58 patients, whereas NWMA were detected in 68 patients with tagging (P=0.002, McNemar). Coronary angiography showed coronary artery disease in 65 (96%) of these 68 patients. All but 3 of the 65 patients needed revascularization. In the 112 patients with a negative dobutamine-CMR study, without baseline wall motion abnormalities, the cardiovascular occurrence-free survival rate was 98.2% during the mean follow-up period of 17.3 months (range, 7 to 31). CONCLUSIONS: Dobutamine-CMR with myocardial tagging detected more NWMA compared with dobutamine-CMR without tagging and reliably separated patients with a normal life expectancy from those at increased risk of major adverse cardiac events.
Kuijpers et al. (Mon,) conducted a observational in known or suspected coronary artery disease (n=211). Dobutamine-CMR with myocardial tagging vs. Dobutamine-CMR without tagging was evaluated on Detection of new wall motion abnormalities (NWMA) (p=0.002). Dobutamine-CMR with myocardial tagging detected significantly more new wall motion abnormalities compared to dobutamine-CMR without tagging (35.1% vs 29.9%; P=0.002).